Swift, Non-Surgical Help to Fix Newborn Ear Deformities

Enlisting newborn hearing screeners
to help identify common ear deformities allows doctors to easily correct the
condition without surgery before a baby leaves the hospital, according to a new
study by researchers at the Perelman School of Medicine at the University of
Pennsylvania. The new study is published online
ahead of print in the International Journal of Pediatric Otorhinolaryngology.

“We’ve known for some time that by simply splinting the ears
of newborns with congenital auricular deformities, we’re able to effectively
reshape the impaired cartilage to prevent the need for future surgery,” said
the study’s senior author, Oren Friedman, MD, director of Facial Plastic Surgery associate professor of
Otorhinolaryngology: Head and Neck.

“But we need to get to these newborns
within the first three days after birth. It made perfect sense to enlist the
help of hearing screeners in this endeavor, as they typically perform an
in-hospital exam on babies within 24 to 48 hours. It is an ideal opportunity to
identify these deformities and allow doctors to take action quickly.”

Congenital auricular deformities are
birth defects affecting the shape and position of the ear. The soft cartilage
around the ear and other structures that affect both the function and
appearance of the ear may be involved. The incidence of these deformities
varies based on the type and between racial and ethnic groups, however
studies have found that up to 30 percent of children have some type of ear
deformity at birth. If left untreated, some of these deformities can cause
significant functional and social impairment, requiring major surgical
intervention at a future date.

In the new study, newborn hearing
screeners received education on evaluation of congenital auricular deformities
by a team of otolaryngologists and were provided an easy to use sheet to keep
with them at all times of photos and illustrations of the most common ear
deformities. When the newborn hearing screeners identified infants with
congenital auricular deformities during a standard hearing exam, the infant’s
primary care medical team was alerted. The primary care team then notified the
family that an otolaryngologist would evaluate the infant’s ears.

During the study timeframe, ten
infants with 19 affected ears amenable to treatment were treated with a simple
splint. All ears were assessed by physical examination and photographic
documentation prior to splinting and at follow-up visits. Splinting was
initiated prior to the infant's discharge from the hospital. All of the
patients exhibited improvement from the original deformity after one to four
weeks of splinting and there were no instances of skin irritation or breakdown.

“In addition to the results from
this study, this technique has been used with great success for many newborns
at Pennsylvania Hospital in the last year,” said Friedman. “We have employed
excellent screening methods utilizing a multi-disciplinary team of experts at
the busiest birthing hospital in Philadelphia to ensure our patients get the
best possible care.”

Friedman and his co-authors note
that over time, this approach may prove to be a cost-effective, minimalist
method to manage the vast majority of congenital auricular deformities. It may
also prove to enhance the psychosocial functioning of children during the
formative years, which can improve their life-long well-being.

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